The West China hospital of Sichuan university has underwent four times emergency medical rescue (EMR) of earthquakes, measuring 5.7 Ms to 8.0 Ms on the Richter scale, happened at Wenchuan, Yushu, Yiliang and Lushan in recent 5 years, which gradually improved and supplemented Wenchuan experience. After Lushan earthquake, a total of 392 patients were received during 2 weeks. Among 321 hospitalized patients, there were 39 (12.15%) patients with critical injury and 14 (4.36%) patients who needed intensive care. 184 operations were performed. Based on the experiences of resource centralization, multidisciplinary cooperation, and hierarchical management, zero death, a new medical record, has been achieved among 43 patients with critical injury after centralized admission and treatment. A total of 12 medical rescue teams involving 88 healthcare workers were sent to the epicenter to join and guide EMR. Besides, rehabilitation and psychological experts came to Lushan on the first day of earthquake, and started clinical intervention of mental and physical health for people needed on the second day.
Objective To discuss the effectiveness of salmeterol in treating a case of chronic obstructive pulmonary disease (COPD). Methods Aimed at the effectiveness of salmeterol in treating COPD patients, a comprehensive search was conducted in EMbase Web (2007 to 2011) and EBSCOhost Web (2000 to 2010) to obtain and evaluate the relevant systematic reviews, meta-analysis and randomized controlled trials (RCTs), and finally to apply the best evidence in clinical practice. Results There were 2 systematic reviews, 3 meta-analyses and 172 RCTs in the initial retrieval; and 12 RCTs and 1 meta-analysis were finally included after being screened. The results indicated a significant improvement in lung function, clinical symptoms and life quality after inhalation of sameterol in COPD patients. The patient had a good effect when the above evidence was applied at the patient’s will. Conclusion The inhalation of salmeterol for COPD can significantly improve lung function, alleviate clinic symptoms and improve life quality of the patients. But there are still some side-effects which should be considered in practical applications.
Early diagnosis of lung cancer is difficult because of it’s lacking in distinctive clinical characteristics. With the development of CT technology for chest, the detection rate of pulmonary nodules is increasing year by year and acquires extensive attention. Therefore, the accurate clinical diagnosis to identify the character of solitary pulmonary nodules is urgently needed. However, the current clinical applications of different diagnosis have pluses and minuses. In this paper, we mainly review the diagnosis, management strategies and the existing problems of solitary pulmonary nodules based on the cancer-screening guidelines of Fleischner Society, American College of Chest Physicians, National Comprehensive Cancer Network, Evaluation of Pulmonary Nodules: Clinical Practice Consensus Guidelines for Asia, and Chinese Consensus on Pulmonary Nodules, and clinical research progress of pulmonary nodules.
Lung cancer in never-smokers has been identified as a separate disease entity. Notably, the proportion of this distinct disease has been reported to increase in recent decades. Due to its occult onset and lack of clinical specificity, patients with this disease are always diagnosed with advanced stage. This review summarizes the current literatures about the risk factors, clinicopathological characteristics, molecular features, and prognosis of lung cancer in never-smokers, which will enhance our understanding and facilitate the precise management of this distinct disease.
Precision medicine is a novel medical modality based on genome sequencing, bioinformatics and big data science. The studies regarding tuberculosis always concentrated on the bacteria and host in the setting of precision medicine. This review mainly introduces the application of precision medicine in the diagnosis and treatment of tuberculosis. The limits of the Chinese studies with respect to precision medicine in tuberculosis are also discussed. Moreover, the article predicates its future development.
The paper summarizes three revolution trends of medical service mode in the age of 5th generation mobile networks (5G), including artificial intelligence & intelligent medical service, internet of things & internet hospital, and intelligent hospital. Artificial intelligence & intelligent medical service mainly covers artificial-intelligence-assisted diagnosis, artificial-intelligence medical decision-making, and artificial-intelligence-assisted new drug research & development. Internet of things & internet hospital mainly covers internet hospitals, internet care, cloud pharmacies, and medical imaging clouds. Intelligent hospitals mainly cover intelligent clinics, intelligent wards, and intelligent management. The revolution trends count on not only techniques such as 5G, but also the support and cooperation of the government and society. The risk of information and data leak needs attention.
With the rapid development of information technology, medical reforms in various countries are moving towards informatization, and internet medical projects have been carried out gradually. Internet hospitals, as one of the manifestations of internet medical projects, have the advantages of improving the efficiency of medical services, revitalizing and effectively sinking high-quality medical resources, and therefore has become the focus of China’s next stage of medical reform. However, internet hospitals are innovative and local products of China, leading its practices lack of domestic and foreign theoretical research, as well as experience, which results in government policies and hospital management strategies are both moving forward in groping, and the construction outcomes vary. Therefore, this article aims to analyze the comprehensive dilemmas currently confronted by internet hospitals in China in different stages of construction, operation and management based on PDCA cycle, and thus, puts forward corresponding construction thinking and analysis in a targeted manner, and proposes guidance for the further development of internet hospitals.
Objective To systematically evaluate the effectiveness and safety of omalizumab in treating allergic bronchial asthma. Methods The randomized controlled trials (RCTs) about omalizumab in treating allergic bronchial asthma were searched in databases such as MEDILINE, EMbase, The Cochrane Library, CBM, CNKI, VIP and WanFang Data from inception to April 2013. The references of included studies and relevant conference proceedings were also retrieved manually. Two reviewers independently screened the literature according to the inclusion and exclusion criteria, extracted the data, and assessed the quality, and then RevMan 5.1 software was used for meta-analysis. Results A total of 13 RCTs involving 4 195 patients were included. The results of meta-analysis showed that: a) Compared with the control group, the trial group revealed lower acute exacerbation of asthma during treatment (RR=0.71, 95%CI 0.65 to 0.77, Plt;0.000 01), and higher rate of patients achieved best/better results in Global Evaluation of Treatment Effectiveness (GETE) (RR=1.61, 95%CI 1.32 to 1.97, Plt;0.000 01). More patients could reduce the inhaled cortisteroid (ICS) by 50% during both treatment (RR=1.40, 95%CI 1.29 to 1.52) and 24-week follow-up period (RR=1.69, 95%CI 1.41 to 2.03). And it also increased the ratio of patients whose Asthma Quality Of Life Questionnaire (AQLQ) score got improved by 0.5 and 1.5 socres. b) There were no significant differences in the incidence of overall adverse events (RR=1.01, 95%CI 0.98 to 1.04) and severe adverse events (RR=0.94, 95CI 0.68 to 1.28). c) There might be the effects of omalzumab in improving lung function and reducing rescue medication use, but they were not obviously observed in the studies. Conclusion In the treatment of asthma, omalizumab can decrease the acute exacerbation of asthma and ICS use, and it is safer to improve the therapeutic effects and quality of life.
Objective An animal model of lung cancer was established to study whether wasabi could inhibit the expression of hnRNP A2/B1 in lung.Methods Thirty-six Wistar rats were randomly divided as model group and wasabi group.0.1 mL of arcinogenic iodized oil [50 mg 3-methylcholanthrene (MCA) in 1 mL carcinogenic iodized oil] were instilled intratracheally to induce lung cancer.A week before instillation of MCA，the wasabi group was orally administered wasabi extract solution until the animals were killed while the model group was given isometric saline at the same time.Six rats in each group were randomly killed on 30th day，60th day and 90th day.Immunohistochemisty and RT-PCR were used to measure the protein and mRNA expression of hnRNP A2/B1，respectively.Results Wasabi lowered the protein expression of hnRNP A2/B1 with a total inhibitory rate of 48.5%.At the 30th，60th and 90th day，the inhibitory rate was 51.0%，51.0% and 45.1% respectively.Meanwhile，wasabi lowered the mRNA expression of hnRNP A2/B1 with a total inhibitory rate of 60.5%.At the 60th and 90th day，the inhibitory rate was 79.5% and 58.0%，respectively.Conclusion Wasabi solution can down-regulate the expression of hnRNP A2/B1 which may be a molecular mechanisms by which wasabi inhibits lung cancer.
Objective To construct small interfering RNA（siRNA） eukaryotic expression vector specific for human hnRNP K gene，and to observe its silencing effects on hnRNP K gene in A549 cells.Methods The expression vectors of pSUPER/hnRNP K siRNAa，pSUPER/hnRNP K siRNAc and pSUPER/siRNAn were constructed by gene recombination and then transfected into the A549 lung carcinoma cell line by using Lipofectamine2000（a and c respectively represented A and C fragments in hnRNP K coding sequence contained 19 nts，n represented nonsense fragment as control）.The mRNA and protein were harvested after 24 h and analyzed for the expression of hnRNP K by RT-PCR and Western blotting respectively.Results The siRNA vector targeted to hnRNP K successfully decreased hnRNP K mRNA and protein levels 24 h after transfection in A549 cells.Relative expressed doses of hnRNP K mRNA in lung cancer cells transfected by hnRNP K siRNAa and hnRNP K siRNAc respectively were 0.24±0.53 and 0.28±0.57 after 24 h，which were significantly lower than that in the control group（both Plt;0.01）.The gray scale values of hnRNP K protein were 0.23±0.11 and 0.28±0.09 respectively，which were also significantly lower than those in the control group（both Plt;0.05）.And pSUPER/hnRNP K siRNAa was the most effective one.Conclusion Eukaryotic expression vector of siRNA specific for hnRNP K is successfully constructed，which lays the basis for the function study of hnRNP K gene and its application in the treatment of lung carcinoma.